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Arkansas rates for HCPCS L5704

Custom Shaped Protective Cover Below Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$357.56 / $357.56 / $357.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.52 / $357.56 / $357.56
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.64 / $514.64 / $514.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.35 / $735.02 / $816.69
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$643.35 / $643.35 / $705.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$705.03 / $705.03 / $705.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$394.91 / $394.91 / $514.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.27 / $394.90 / $502.58
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591.84 / $591.84 / $591.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.20 / $320.93 / $485.86